Acta anaesthesiologica Belgica
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Acta Anaesthesiol Belg · Jan 2014
Randomized Controlled Trial Comparative StudyGabapentin versus naproxen in the management of failed back surgery syndrome; a randomized controlled trial.
Gabapentin is an analogue of the gamma amino butyric acid (GABA), which regulates the conductance of calcium channels. In this study, we compared the efficacy of gabapentin the one of naproxen in the treatment of failed laminectomy syndrome. In this controlled trial, patients who had had elective lumbar discectomy or spinal fusion surgery more than one year ago, and complaining about leg and back pain in spite of different medical therapy were randomly assigned to receive naproxen (control group) or gabapentin. ⋯ At 1800 mg, the reduction in VAS was 39.2%. Naproxen-treated patients had a 7.7% pain reduction at 6th week, when using the maximum daily dose of 1500 mg (P < 0.04), but the pain increased thereafter. We conclude that Gabapentin, at a maximum daily dose of 1800 mg, is significantly more efficient than naproxen at treating persistent pain after spinal surgeries.
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Acta Anaesthesiol Belg · Jan 2014
Randomized Controlled TrialThe effect of chewing lidocaine soaked gauze on intubation conditions during awake videolaryngoscopy: a randomised controlled trial in the morbidly obese.
The increasing utilisation of the videolaryngoscope for awake tracheal intubation requires development and assessment of methods to decrease the gag reflex. We hypothesised that chewing gauze soaked with lidocaine would decrease the gag reflex during awake videolaryngoscope tracheal intubation. Twenty four morbidly obese patients assessed as having a potential difficult tracheal intubation were randomised to chew gauze soaked with 20 ml of 2% lidocaine or saline for 3 minutes. ⋯ The primary outcome was the gagging score at best laryngeal visualisation, which was compared between groups with a Student's t-test. Gagging scores and hemodynamic parameters did not differ between groups, but the saline group had lower plasma levels of lidocaine after the intubation procedure. When used for awake videolaryngoscope assisted tracheal intubation of the morbidly obese, chewing lidocaine soaked gauze does not decrease the amount of gagging as compared to lidocaine aerosolisation, but does increase the plasma levels of lidocaine.
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Acta Anaesthesiol Belg · Jan 2014
Randomized Controlled Trial Comparative StudyA comparison of the effects of lidocaine or magnesium sulfate on hemodynamic response and QT dispersion related with intubation in patients with hypertension.
The aim of this study was to investigate the effect of magnesium administered before induction on the hemodynamic response and QT dispersion (QTd) related with intubation in hypertensive patients and to compare it with lidocaine. ⋯ QTd is not increased during tracheal intubation in hypertensive patients so there is no need for magnesium sulfate for these patients. But as QTd has been shown to increase during tracheal intubation for coronary artery disease patients, magnesium sulfate might be useful for those patients although future studies are required to confirm this statement.